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      Enteric pathogens in German police officers after predominantly tropical deployments – A retrospective assessment over 5 years

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          Abstract

          Introduction

          The study was performed to assess the infection risk of German police officers on predominantly tropical deployments, mostly United Nations missions, with gastrointestinal pathogens.

          Methods

          Police officers were offered PCR-based screening for gastrointestinal pathogens before and after deployment. The screening panel comprised enteroinvasive bacteria ( Salmonella spp., Shigella spp./enteroinvasive Escherichia coli, Campylobacter jejuni, and Yersinia spp.), enteropathogenic protozoa ( Entamoeba histolytica, Giardia duodenalis, Cryptosporidium spp., and Cyclospora cayetanensis), as well as enteric helminths ( Ancyclostoma spp., Ascaris lumbricoides, Enterobius vermicularis, Hyme-nolepis nana, Necator americanus, African Schistosoma spp., Strongyloides stercoralis, Taenia saginata, Taenia solium, and Trichuris trichiura).

          Results

          G. duodenalis ( n = 3), C. jejuni ( n = 2), Salmonella spp. ( n = 1), Shigella spp./enteroinvasive E. coli ( n = 3), and S. stercoralis ( n = 3) were detect in 12 out of 133 (9.0%) police officers. The majority had shown gastrointestinal symptoms on deployment and all were asymptomatic at the time of medical assessment. The major infection sites were Sub-Saharan Africa followed by Northern Africa and the Middle East.

          Conclusions

          Deployment of police officers to tropical deployment sites on United Nations missions is associated with a considerable acquisition risk of gastrointestinal pathogens in a quantitatively relevant minority. Post-deployment screening is advisable to facilitate therapeutic and hygiene-related consequences.

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          Most cited references20

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          High Rate of Acquisition but Short Duration of Carriage of Multidrug-Resistant Enterobacteriaceae After Travel to the Tropics.

          Multidrug-resistant Enterobacteriaceae (MRE) are widespread in the community, especially in tropical regions. Travelers are at risk of acquiring MRE in these regions, but the precise extent of the problem is not known.
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            Import and spread of extended-spectrum β-lactamase-producing Enterobacteriaceae by international travellers (COMBAT study): a prospective, multicentre cohort study.

            International travel contributes to the dissemination of antimicrobial resistance. We investigated the acquisition of extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-E) during international travel, with a focus on predictive factors for acquisition, duration of colonisation, and probability of onward transmission.
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              Acute and potentially life-threatening tropical diseases in western travelers--a GeoSentinel multicenter study, 1996-2011.

              We performed a descriptive analysis of acute and potentially life-threatening tropical diseases among 82,825 ill western travelers reported to GeoSentinel from June of 1996 to August of 2011. We identified 3,655 patients (4.4%) with a total of 3,666 diagnoses representing 13 diseases, including falciparum malaria (76.9%), enteric fever (18.1%), and leptospirosis (2.4%). Ninety-one percent of the patients had fever; the median time from travel to presentation was 16 days. Thirteen (0.4%) patients died: 10 with falciparum malaria, 2 with melioidosis, and 1 with severe dengue. Falciparum malaria was mainly acquired in West Africa, and enteric fever was largely contracted on the Indian subcontinent; leptospirosis, scrub typhus, and murine typhus were principally acquired in Southeast Asia. Western physicians seeing febrile and recently returned travelers from the tropics need to consider a wide profile of potentially life-threatening tropical illnesses, with a specific focus on the most likely diseases described in our large case series.
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                Author and article information

                Journal
                Eur J Microbiol Immunol (Bp)
                Eur J Microbiol Immunol (Bp)
                EUJMI
                European Journal of Microbiology & Immunology
                Akadémiai Kiadó (Budapest )
                2062-509X
                2062-8633
                05 October 2020
                14 October 2020
                : 10
                : 3
                : 172-177
                Affiliations
                [1 ] Department of Tropical Medicine and Infectious Diseases, Bundeswehr Hospital Hamburg , Hamburg, Germany
                [2 ] German Federal Police , Potsdam, Germany
                [3 ] Department of Microbiology and Hospital Hygiene, Bundeswehr Central Hospital Koblenz , Koblenz, Germany
                [4 ] Department of Microbiology and Hospital Hygiene, Bundeswehr Hospital Hamburg , Hamburg, Germany
                [5 ] Institute for Medical Microbiology, Virology and Hygiene, University Medicine Rostock , Rostock, Germany
                Author notes
                *Corresponding author. Department of Microbiology and Hospital Hygiene, Bundeswehr Hospital Hamburg, Bernhard Nocht Str. 74, D-20359 Hamburg, Germany. E-mail: Frickmann@ 123456bni-hamburg.de
                Article
                10.1556/1886.2020.00026
                7592512
                33021951
                693dfee5-e579-4f84-b8c8-4c5c4046ebeb
                © 2020, The Authors

                Open Access. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License ( https://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted use, distribution, and reproduction in any medium for non-commercial purposes, provided the original author and source are credited, a link to the CC License is provided, and changes - if any - are indicated.

                Page count
                Figures: 1, Tables: 2, Equations: 0, References: 20, Pages: 6
                Categories
                Original Research Paper

                police,deployment,infectious disease,tropics,epidemiology,united nations

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